During the last decade we have seen dramatic changes in the epidemiology and incidence of tuberculosis in the United States. Despite improved methods of diagnosis and treatment, tuberculosis is increasing. Likewise, in San Francisco, tuberculosis cases have increased and occur disproportionately in certain high risk groups including; HIV-infected persons, African-Americans, Hispanics, and the foreign-born. Over the last 3 decades as tuberculosis cases diminished, so did tuberculosis education. Medical students at the University of California, San Francisco, as well as housestaff, postgraduate fellows, and faculty receive an inadequate amount of training in tuberculosis and tuberculosis control. Moreover, the San Francisco community has little means of learning about this increasing public health threat. The primary goals of the curriculum development program in this application are the following: 1) to provide an integrated curriculum in tuberculosis that emphasizes principles and practices relevant to tuberculosis and tuberculosis control at all levels of medical education; 2) to improve tuberculosis education in the San Francisco community focusing on those providers caring for 'high risk' clients; 3) to develop a faculty capable of providing high quality tuberculosis instruction. The proposed curriculum development plan involves the following major components; a) creation of a multidisciplinary advisory committee; b) development of instructional materials that emphasize the importance of tuberculosis and tuberculosis control in case-based problem solving sessions; c) increased didactic and case-based teaching during the clinical rotations of medical students as well as housestaff and postgraduate fellows; d) training of faculty responsible for tuberculosis education; e) improved continuing education in tuberculosis for community physicians and health care workers through a number of innovative courses and collaborations with the Department of Public Health, the Tuberculosis Training Center, and other community organizations. Research related to tuberculosis control will be fostered by support of student research projects as well as the continuation of the candidate's research program and the many collaborations that will result from this award. Evaluation of the curriculum development program will be conducted by an experienced group of physicians and educators through a stepwise and analytical manner.
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